Provider Demographics
NPI:1639145139
Name:BUKHARI, NAYER S (MD)
Entity Type:Individual
Prefix:DR
First Name:NAYER
Middle Name:S
Last Name:BUKHARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 REDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06073-2912
Mailing Address - Country:US
Mailing Address - Phone:860-633-7602
Mailing Address - Fax:
Practice Address - Street 1:SAINT FRANCIS HOSPITAL AND MEDICAL CENTER
Practice Address - Street 2:114 WOODLAND STREET, MS70102
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1299
Practice Address - Country:US
Practice Address - Phone:860-714-4912
Practice Address - Fax:860-714-8004
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0228062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1228065Medicaid
CTD80817Medicare UPIN
CTD80817Medicare ID - Type Unspecified